Manager, PFS Operations Revenue Cycle

UT Southwestern Medical Center • Dallas, TX

1d • Remote

About The Position

The Revenue Cycle PFS Operations Manager – Back End is responsible for overseeing all hospital billing operations, government payer follow-up, denial management, and accounts receivable performance to support optimal reimbursement and revenue cycle outcomes. This role provides leadership to two direct reports and approximately 20–25 indirect team members, driving operational excellence across billing, DNB management, transplant network billing, and reimbursement workflows. The ideal candidate will have extensive hospital revenue cycle experience, strong Epic proficiency, and a proven ability to improve performance through data-driven decision-making. Must have EPIC experience. Experience with clinical denials management and appeals is highly preferred. Work From Home - Candidates must live in TX, DFW area is preferred. Shift - Monday through Friday, 8-hour flex.

Requirements

• 5 years of hospital billing / operations to include federal, state, third party payors, research & transplant.
• 3 years of progressive supervisory / management experience with extensive knowledge of Patient of Financial systems & processes including the healthcare revenue cycle, coding & billing compliance.
• Proven record of identifying PI opportunities.
• Requires strong negotiating, analytical & organizational skills as well as the ability to be flexible with changing needs & deadlines; the ability to interact & communicate both verbally & in writing with all levels of associates, mgmt & patients.
• Must have EPIC experience.

Nice To Haves

• Experience with clinical denials management and appeals is highly preferred.
• DFW area is preferred.

Responsibilities

• Manages daily operation of all Hospital Billing to ensure all charges are processed and billed in a timely manner to include Federal, State, and Third Party Payors. (Billing and Collections of all Federal/State Payors i.e. Medicare/Medicaid). Responsible for daily exporting of claims from billing system to claim editor. Daily reconciliation between systems.
• Manages research and client billing & collections. Maintaining appropriate fee schedules.
• Manages billing/collection of Solid Organ & BMT services to include acquisition, pre/post transplant. Manages Special Billing protocols to include package plans, self pay, intl. patient billing, purchased services, workers comp & occupational billing, & other clinical departments, etc. Maintains appropriate fee schedules.
• Coordinates all workflow issues and accounts concerns with Supervisors, peers, and leadership. Ability to properly delegate and prioritize work demands to meet or exceed financial goals and objectives of the department. This includes monitoring quality and quantity of work, performing Quality Reviews (QA's).
• Manages, trains, and structures staff to achieve the quality and quantity of work and service provided by team to ensure team meets production, billing and cash goals set for the department. Ensures system work lists and settings are providing the best work source for staff. Conducts meetings and works with staff identifying payor reimbursement issues. Assist in performing analysis to determine root causes (payor or hospital), for payment variance issues and resolution.
• Analyzes, recommends, & implements policies & procedures as needed to maximize reimbursement for services rendered in compliance with established government & third party guidelines. Close collaboration with hospital department managers to ensure timely charge submittal. Close collaboration with HIM/Coding Audit & Denial teams.
• Acquires and maintains thorough knowledge of Federal & State Legislative & Administrative action affecting reimbursement; disseminates acquired knowledge to leadership. "Risk Reporting" monthly as outlined by Office of Compliance .
• Audits posting of payments for purchased services, client & research billing. Coordinates all workflow issues & account concerns with PFS leadership.
• Performs other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100%25 coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed